ELEVATE Volunteer General Information Form

Phone number *

Address

EMERGENCY CONTACT INFORMATION

Emergency Contact Name *

First and Last Name

Relationship *

Emergency Contact Phone *

Birthdate *

Gender

Social Security Number *

Used to conduct a criminal background check in accordance with current standards concerning volunteers.

What day(s) are you interested in serving *

Check all that apply

Mondays

Tuesdays

Wednesdays

Thursdays

Fridays

What time of day are you interested in serving *

Interested in serving on Field Trip days *

Typically the first Friday of the month. All day event (8-3:30pm)

Please list previous volunteer experience: What type of volunteering, with whom did you volunteer, your volunteer responsibilities in the past?

Medical note

Please list any medical needs we should be aware of, such as allergies, seizures, or conditions that may limit your ability to serve.